People with diabetes, asthma, and other conditions often pay higher prescription costs that effectively subsidize healthier plan enrollees, researchers say
Medicare enrollees are paying far more than their prescription-drug plans for dozens of drugs covered under Medicare Part D, according to a new study from the U.S. Government Accountability Office.
Part D plan sponsors got more than $48 billion in rebates from drug companies in 2021, but the patients who take the medicines that are generating all those savings are losing out, the study suggests. The reason: Medicare Part D enrollees’ costs at the pharmacy counter are based on the drug’s gross cost before any rebates, the GAO said.
About 50 million people are enrolled in Medicare Part D prescription-drug coverage. Total Part D spending topped $200 billion in 2021. Looking at 40 highly rebated brand-name drugs and their generic equivalents, for example, the GAO found that about a quarter of the Part D plans studied listed the brand-name drug on their formularies but not the generic alternative. Nearly 80% of the rebate dollars for those drugs were paid to plans that did not list the generic alternative on the formulary, the study found.
Greg Lopes, spokesperson for the Pharmaceutical Care Management Association, a PBM trade group, said in a statement that the GAO report “again confirms that rebates negotiated by pharmacy benefit companies are lowering Medicare Part D program costs and reducing premiums for beneficiaries.” Removing rebates from the Part D program, he said, could significantly increase costs to taxpayers as well as premiums for beneficiaries.
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